![]() Kruger A, Oberkircher L, Frangen T, Ruchholtz S, Kuhne C, Junge A (2013) Fractures of the occipital condyle clinical spectrum and course in eight patients. Review of the literature and case report. Īlcelik I, Manik KS, Sian PS, Khoshneviszadeh SE (2006) Occipital condylar fractures. Karam YR, Traynelis VC (2010) Occipital condyle fractures. Prospective follow-up of 31 cases within 5 years at a level 1 trauma centre. Mueller FJ, Fuechtmeier B, Kinner B, Rosskopf M, Neumann C, Nerlich M, Englert C (2012) Occipital condyle fractures. īoughton OR, Bernard J, Szarko M (2015) Odontoid process fractures: the role of the ligaments in maintaining stability. Van Middendorp JJ, Audigé L, Hanson B, Chapman JR, Hosman AJF (2010) What should an ideal spinal injury classification system consist of? A methodological review and conceptual proposal for future classifications. īucholz RW, Burkhead WZ, Graham W, Petty C (1979) Occult cervical spine injuries in fatal traffic accidents. Īlker GJ, Oh YS, Leslie EV, Lehotay J, Panaro VA, Eschner EG (1975) Postmortem radiology of head neck injuries in fatal traffic accidents. Jea A, Tatsui C, Farhat H, Vanni S, Levi AD (2006) Vertically unstable type III odontoid fractures: case report. Skelet Radiol 29:125–132īellabarba C, Mirza SK, West GA, Mann FA, Dailey AT, Newell DW, Chapman JR (2006) Diagnosis and treatment of craniocervical dislocation in a series of 17 consecutive survivors during an 8-year period. ĭaffner RH, Brown RR, Goldberg AL (2000) A new classification for cervical vertebral injuries: influence of CT. Joaquim AF, Ghizoni E, Tedeschi H, Lawrence B, Brodke DS, Vaccaro AR, Patel AA (2014) Upper cervical injuries - a rational approach to guide surgical management. White AA, Panjabi MM (1978) Clinical biomechanics of the spine. The development of a newly classification system concerning ligamentous instability with a high clinical and scientific impact is recommended. The integrity of tectorial membrane and alar ligaments determines the stability of atlanto-occipital dislocation. The integrity of anterior longitudinal ligament, disc, and facet joint attributes to the stability of axis fractures. The transverse ligament serves as the most crucial element in determining the stability of occipital condyle fractures and atlas fractures as well as atlanto-axial injury. ![]() The ligamentous integrity is the key element of impacting the stability of the upper cervical spine injuries. ![]() Only a few classification systems support decision-making concerning instability leading to early operative treatment. CT scan is more sensitive and reliable than X-ray in detecting misalignment of the upper cervical spine. The status of crucial ligaments plays a key role in determining instability of upper cervical spine injuries. The determinants involve translation, vertical distraction, angulation, rotation, obliquity of fracture line, comminution, and ligamentous disruption. Various instability criteria were established as well. The recent classifications pay more attention to the investigation of ligamentous status. The early classifications are based primarily on injury morphology and mechanism. Numerous separate classification systems for each specific injury of the upper cervical spine were obtained. ![]() An English literature search was conducted using various combinations of keyword terms. MethodsĪ systematic review of literature concerning upper cervical spine injuries was performed on the PubMed database from inception to December 2019. Since identifying unstable injuries of the upper cervical spine is essential for immediate stabilizing therapy, this article reviews the current classification systems of upper cervical spine injuries and their statements towards instability. The diagnosis of instability of the injured upper cervical spine remains controversial, due to its complicated anatomical configuration and biomechanical property.
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